Dear Colleagues,

Last week marked the beginning of my term as President.  I am honoured to serve as the 64th President of the OCFP. I am committed to ensuring we provide you with the tools and resources you require to excel in your practice, and we will continue to advocate to government to address the barriers that you face as family physicians. I look forward to leading the OCFP as we continue building a strong, vibrant profession of family medicine across Ontario.

I would like to acknowledge the efforts of our outgoing President, Dr. Elizabeth Muggah. I am grateful for her leadership and advocacy in support of family physicians through one of the most challenging periods in our health system’s history.

Please see this video that Dr. Muggah sent for all members.

In this message:

• Advocacy and research
• Community of Practice
• COVID-19 bivalent vaccine
• COVID-19 vaccine for infants and children
• Evusheld and Paxlovid for COVID-19
• Long COVID
• Flu resources
• Mental health and addictions supports for patients and physicians
• Other opportunities

Advocacy and Research

• Our 13 news release garnered attention in the Globe and Mail, CBC Radio, CTV News and more. See our OpEd.
• See this new report from Ontario’s Science Table (Oct. 3) focusing on the important role that family physicians are playing in supporting patients through the pandemic and beyond.
• Bill 7, with a stated focus on Health System Stability and Recovery, took effect Sept. 21. See the memo and summary from OH and MOHLTC outlining the role of Primary Care.
• We are partnering on the OurCare research project on the future of primary care, led by Dr. Tara Kiran. Please share the survey with patients.
• See our joint recommendations for strengthening mental healthcare delivery in primary care, released in this policy paper developed with our partners in the Primary Care Collaborative and the OMA.

Community of Practice (CoP)

• Join our 50^th COVID-19 CoP with UofT DFCM on Oct. 7, 7:55 a.m. We will discuss COVID boosters, flu shots, catch-up immunizations and more, with panellists Dr. Allison McGeer, Dr. Nicole Blackman and Dr. Daniel Warshafsky. REGISTER
• Join the next Practising Well CoP session on Helpful Strategies to Address Mental Health in Children. REGISTER

COVID-19 Booster – Bivalent Vaccine

MOH’s updated COVID-19 Vaccine Guidance (Sept. 26) includes recommendations for the fall booster. The OCFP has curated Q&As. Also, see this one-pager from Dr. Kelly Grindrod and her team at the University of Waterloo.

• At present, the bivalent vaccine is authorized as a booster.
• The bivalent booster is recommended for individuals aged 18 years and older. Youth aged 12 to 17 with moderately to severely immunocompromising conditions, or those who have biological or social risk factors, may also receive the bivalent vaccine.
• High-risk groups, including healthcare workers and pregnant individuals 18 years and older (full list on pp. 10-11 of Guidance), are recommended to get a bivalent booster as soon as possible following the three-month minimum interval, regardless of how many previous boosters.

COVID-19 Vaccine – Infants and Children

• Pfizer’s vaccine for children 6 months to under 5 years has been authorized by Health Canada and is now available in Ontario. See Vaccine Guidance and some reminders:
  • Children are not eligible for the bivalent vaccine (exceptions are moderately to severely immunocompromised youth between 12 to 17 years old, as explained above).
  • Infants and children 6 months to under 5 years of age are not eligible for booster doses currently. For this group, Pfizer is a three-dose primary vaccine series (versus two doses for the Moderna vaccine).
  • Infants and children of any age should receive the same vaccine, either Pfizer or Moderna, for all doses in a primary series – especially important for children receiving Moderna 25 mcg and Pfizer 3 mcg, given the difference in the number of doses in the primary series. (See Vaccine Guidance, Primary Series Recommendations, page 6)
• A booster dose of the monovalent Pfizer vaccine is recommended for children aged 5 to 11 who have underlying medical conditions.
• Re-sharing these resources from SickKids: Vaccine Consult Service and online resources for COVID-19 vaccination for ages under 5.

COVID Pre-Exposure Prophylaxis – Evusheld

Under updated guidance (Oct. 3), family physicians can prescribe and administer Evusheld, and local pharmacies can dispense. Evusheld is still accessible through hospital-based clinics, i.e., cancer and transplant programs and some clinical assessment centres. Check with your Ontario Health (OH) regional contact to find out how to access Evusheld. This OH memo summarizes current eligibility and access and here is information for healthcare providers.

• Evusheld is for individuals 12+ who weigh at least 40 kg and who do not have COVID-19 infection or a known recent exposure and are up to date on vaccines. From OH: patient handout.

COVID-19 Treatments – Paxlovid and remdesivir

• Paxlovid and remdesivir continue to be options for treating eligible patients with COVID and at risk of progression to severe disease. Paxlovid must be taken within 5 days of the start of symptoms; remdesivir, within 7 days, as an alternative to Paxlovid based on clinical assessment. See Ontario Health guidance and contact your regional OH contact for local pathways.
  • Ontario Health Paxlovid patient factsheet
  • Science Advisory Table Paxlovid guidance
  • Confused About COVID: If I get COVID, is there a medication I can take?
  • OCFP President’s Message: Prescribing Paxlovid, Patient Resources and more

Long COVID

• The MOH said it intends to address the burden of long COVID with a comprehensive plan. The OCFP will continue to share information, including through our web repository and in the COVID-19 Community of Practice:
  • Session recordings, Q&As and more resources on long COVID. Recent sessions include long COVID (Sept. 16).
• What to look out for in primary care and when to refer in an updated visual summary from Dr. Trisha Greenhalgh et al (Sept. 22) and in the full BMJ Practice Pointer
• Ontario Science Table’s report on long COVID (Sept. 7) includes current evidence on prevalence, impacts, treatments, expected burden and more.
• The CEP has updated its COVID-19 resource centre to include information on long COVID.

Flu Resources

• See Ontario’s updated Universal Influenza Immunization Program (UIIP) for 2022/23, for information on timing, product availability and ordering, vaccines for specific age groups, and more.
• A noted caution is that Fluzone® Quadrivalent and Fluzone® High-Dose Quadrivalent are different products; Fluzone® Quadrivalent is authorized for those 6 months and older and High-Dose Quadrivalent is authorized only for those aged 65 and older. Please use caution when administering Fluzone® products to ensure that the right vaccine is being administered to the right person.

Mental Health and Addictions

• For healthcare organizations: Canadian Mental Health Association’s (CMHA) Your Health Space is a free service to help address chronic workplace stress. Register: Oct.17, Oct. 18,  Oct. 24, Oct. 27.
• Also from CMHA, resources for healthcare providers to help your patients with cancer manage depression, anxiety, and fear of recurrence: webinar, Tuesday Oct. 18, 12 to 1 p.m. REGISTER
• Ontario Health’s “Breaking Free” program is a free online support tool to help Ontarians ages 16 and older reduce or stop the use of over 70 substances, such as tobacco, alcohol and drugs, including opioids. Healthcare providers who join the program can offer it to their clients to self-enroll – contact the program directly to get a service code to give your patients.

Other Opportunities

• This year’s Practical Evidence for Informed Practice (PEIP) Conference from PEER takes place virtually and in-person in Edmonton, Oct. 21 and Oct. 22. Learn more and register
• Public Health Ontario is hosting regional sessions to support those who oversee or implement infection prevention and control in Primary Care settings. More information and regional registration information is available on the AFHTO website.
• Ontario Health is seeking expressions of interest for the position of Provincial Clinical Co-Lead, Ontario Palliative Care Network. The deadline for applications is Oct. 24. Learn more| download Expression of Interest form
• Find out about OMA’s Physician Leadership Program at an informational webinar with OMA President Dr. Rose Zacharias and CEO Allan O’Dette, and FAQs on the OMA website (login required).

Finally, for those who were not able to join the Annual Members Meeting on Sept. 28, we welcome you to check out our Year in Review.

As I sign off, I would like to express my gratitude to all of you for your hard work and dedication.  Thank you for all that you do.

Mekalai